Table of Content

21 October 2021, Volume 42 Issue 5

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Laboratory Medicine and Clinic

Effect of EPHX2 rs751141 mutation on renal microinflammation and its molecular mechanism

Ma Liang, Zhao Hailing, Zhao Tingting, Zhao Meimei, Liu Yi, Gao Peng, Li Ping, Cao Yongtong

2021, 42(5):  691-697.  doi:10.3969/j.issn.1006-7795.2021.05.001

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Objective To study the effect of EPHX2 rs751141 polymorphism (G860A, R287Q) on the activity of soluble epoxide hydrolase (sEH) and the molecular mechanism of its involvement in renal microinflammation. Methods With human renal tubular epithelial cells (HK2) cDNA used as a template, the recombinant plasmids pcDNA3.1/V5-His-G (wild type, WT) and pcDNA3.1/V5- His-A (mutant: R287Q) containing EPHX2 rs751141 alleles G and A were constructed using p-UCT DNA linkage kit, point mutation technique and subclone technique. The recombinant plasmids were transfected into HK2 cells with Lipofectamine2000 transfection reagent and co-cultured with 11,12-epoxyeicosatrienoic acid (11,12-EET). The level of 11,12-dihydroxyeicosatrienoic acid (11,12-DHET) was detected by ELISA kit and the effect of R287Q mutation on the activity of sEH was analyzed by T test. The levels of IL-17A and IL-1 in supernatants were measured by flow cytometry technique. The levels of IL-17A and IL-1β mRNA were detected by RT-PCR, and PI3K/AKT signal pathway related protein were detected by Western Blot. Results Compared with WT group, the hydrolytic activity of R287Q group was significantly decreased (P<0.01), and the levels of IL-17A and IL-1 in supernatant were significantly decreased (P<0.05). Compared with WT group, the level of inflammatory factors in WT+EET group was significantly lower, but still higher than that in R287Q+EET group (P<0.05). The mRNA expression of IL-17A and IL-1β in the R287Q mutation group was significantly lower than that in the WT group, and the mRNA expression of IL-17A and IL-1β in the WT+EET group was significantly lower than that in the WT group, but still higher than R287Q + EET group (P<0.05). Western blotting results indicated that R287Q group may modulate PI3K/AKT signaling pathway to reduce inflammation in renal tubular epithelial cells. Conclusions R287Q group decreased the hydrolytic ability of 11,12-EET and significantly reduce inflammation, while exogenous 11,12-EET reduce inflammation in WT group. The renal protection of EPHX2 rs751141 allele A may be involved in the molecular mechanism by regulating the PI3K/AKT signaling pathway.

Value assigned and application of trueness verification materials of serum electrolytes

Zhang Rui, Zhang Shunli, Liu Wensong, Li Huiling, Wang Ning, Yue Yuhong, Wang Qingtao

2021, 42(5):  698-705.  doi:10.3969/j.issn.1006-7795.2021.05.002

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Objective To determine the accurate values of serum electrolytes sodium (Na), potassium (K), magnesium (Mg) and calcium (Ca) by ion chromatography reference method, and to apply to the trueness verification of Beijing Center for Clinical Laboratories. Methods Using the established reference method by ion chromatography, the developed three concentration levels (batch numbers BCCL01, BCCL02 and BCCL03) of human serum matrix electrolyte correctness verification materials were determined, and the electrolyte standard reference materials standard reference material (SRM) 919b, SRM 918b, SRM 929a and SRM 915b from the National Institute of Standards and Technology (NIST)were used for quantity transfer. The five levels of sodium, potassium, magnesium and calcium composite ion standard solutions with NIST electrolyte reference materials were prepared to standard curves, the low, medium and high levels correctness verification materials were assigned values and the corresponding uncertainty were calculated. This substance was used to carry out the correctness verification plan in 23 laboratories in Beijing. The correctness verification samples were distributed by Beijing clinical testing center and the results were statistically reported on time. According to Clinical Laboratory Standards Institute (CLSI) EP-17A2, the covariance model and Westgard model are used to estimate the total laboratory error. Results The determination results of three batches of serum electrolyte sodium from correctness verification substance were 125.6-159.1 mmol/L respectively, potassium was 6.134-3.027 mmol/L respectively, magnesium was 1.389-0.539 mmol/L respectively, calcium was 3.083-2.197 mmol/L respectively. The results of Westgard model are similar to the results of 100% passing rate of participating laboratories, while the results of covariance model are only similar to the results of 60% passing rate. Conclusion In this study, the accurate and reliable reference method of ion chromatography is used to assign value of electrolyte sodium, potassium, magnesium and calcium, which can be used to evaluate the accuracy of conventional detection methods in clinical laboratory. Compared with the covariance model, Westgard model is more suitable for the reflection of detection level of the laboratory, so it is recommended that clinical laboratories use Westgard model to estimate the total error in the determination of serum cations.

Comparative study of patient-based quality control (PBQC) and traditional quality control methods

Liu Yu, Zhang Shunli, Yue Yuhong, Zhang Rui

2021, 42(5):  706-714.  doi:10.3969/j.issn.1006-7795.2021.05.003

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Objective To compare the patient-based quality control(PBQC)with the traditional quality control method in some biochemical items detection, increase the interoperability and correlation between routine quality control data and clinical patient data, and improve the accuracy of detection results. Methods The data of blood glucose (Glu), glycosylated albumin (GA), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), and blood homocysteine (HCY) within the normal reference range from 18 to 55 years old were collected continuously for 25 days to obtain the daily mean and median. The routine quality control data of the above biochemical test items in the same period were collected. The total mean, median and standard deviation were calculated with 6σ the quality management methods to evaluate the performance of moving average method, moving median method and conventional quality control method based on patient data. The patient data for another 20 days were collected, with a positive deviation of 5%, and compared with the data of the previous 25 days. Whether the patient was in control or not was judged according to the Westgard quality control rules. Results In the routine quality control methods, Glu, GA, HbA1c, TG, TC, and HCY were the most important, with the σ values 2.85, 0.89, 3.64, 15.03, 5.14 and 2.83 respectively, corresponding to the performance evaluation medium, poor, good, excellent, excellent, and medium. Based on the moving mean method and median method of patient data, the changes of Glu, GA, HbA1c, TG, TC and HCY were analyzed, with the σ values 3.05, 2.90; 2.63,1.58; 4.49,0.84; 3.38,2.45; 4.39,3.59; and 1.61,0.93; respectively, corresponding to the performance evaluation good, medium; medium, poor; excellent, poor; good, medium; excellent, good; and poor, poor. The out of control of other detection items except triglyceride could be detected by PBQC method with 5% error. Conclusion Under the comprehensive evaluation of 6 σ quality management, the moving average method of PBQC and the conventional quality control method was compared with each other, and their performance was equivalent and complementary. The moving average method of PBQC on Glu, GA and HbA1c projects performed better, whilst routine quality control method on TG and HCY project was better. The moving average method of PBQC could be used as an effective quality control method to assist conventional quality control.

Study on the application value of serum neuron-specific enolase in diagnosis and therapeutic effect on patients with traumatic brain injury

Wang Li, Zhang Guojun

2021, 42(5):  715-720.  doi:10.3969/j.issn.1006-7795.2021.05.004

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Objective To explore influences of the level and dynamic changes of neuron-specific enolase (NSE) in serum on the early diagnosis, classification, condition change and prognosis assessment of traumatic brain injuries (TBI) patients. Methods A total of 106 TBI patients admitted to a hospital in Yanqing District of Beijing were divided into mild, moderate, and severe groups, according to Glasgow Coma Score (GCS) at admission. Based on the injury types diagnosed by CT, the patients were divided into subdural, epidural hematoma, subarachnoid hemorrhage group (hematoma hemorrhage group for short), brain contusion and laceration group, diffuse axonal injury group, and no obvious abnormalities group. After 3 months of follow-up, the patients were divided into poor prognosis group and good prognosis group according to Glasgow Outcome Score (GOS). Totally 100 healthy patients were selected as the control group. The serum NSE levels of experimental groups and control group were detected on day 1, 3 and 5, and the differences of serum NSE levels among all groups were compared and the correlation analysis was conducted. The receiver operating characteristic (ROC) curve was prepared to evaluate the diagnostic efficacy of serum NSE level as the prognostic criteria of patients. Results The level of serum NSE in TBI group was significantly higher than that in healthy control group, and the level of serum NSE in mild group was lower than that in moderate and severe groups. The dynamic level of serum NSE in mild and moderate groups showed a downward trend, while that in severe group was increased first and then maintained a high level. Among the injury groups diagnosed by CT, the level of serum NSE in the patients with diffuse axonal injury was significantly higher than that in the other groups. The serum NSE level was negatively correlated with GCS and GOS scores of the TBI patients at admission. The ROC curve evaluation showed that the serum NSE level had significant predictive value for the prognosis of the TBI patients 3 months after injury. Conclusion As an objective and reliable biomarker to judge the degree of craniocerebral injury, the serum NSE level has certain clinical application value in the diagnosis and classification of traumatic brain injury, disease progression and prognosis evaluation.

The comparative analysis of several biomarkers in the cerebrospinal fluid of multiple sclerosis and neuromyelitis optica spectrum disorders

Shi Lili, Wang Jinling, Wang Yifei, Li Lei, Wang Peichang

2021, 42(5):  721-725.  doi:10.3969/j.issn.1006-7795.2021.05.005

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Objective To observe the changes of several biomarkers, including ALB, immunoglobulin and complements,etc, in the serum and cerebrospinal fluid(CSF) of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), and to explore the significance of each index in the diagnosis as well as differential diagnosis of the two diseases. Methods A total of 91 patients with central nervous system demyelinating diseases were enrolled,including 33 MS patients and 58 NMOSD patients. Fifty patients with Headache (HA) were selected as non-inflammatory control group. The blood and CSF specimen were collected. ALB, IgA, IgG, IgM in the serum and CSF as well as C3, C4 in the serum were measured. The ratio of IgA, IgG, IgM,ALB in the serum and in CSF as IgA Q, IgG Q, IgM Q,ALB Q and the index of 24 h intrathecal synthesis rate and ALB Q>Qlim (ALB) were counted. The difference of the biomarkers in MS and NMOSD patients were analyzed. Results The levels of CSF IgG, IgG Q, 24 h intrathecal synthesis rate and the ratio of ALB Q>Qlim (ALB) in MS and NMOSD group were statistically significant higher than that in control group(P<0.05). Moreover, the 24 h intrathecal synthesis rate and IgG Q of MS group were significantly higher than that of NMOSD group(P<0.05). Conclusion Both MS and NMOSD featured in the impaired blood-brain barrier function, but it could be differentiated with intrathecal IgG synthesis between MS and NMOSD.

Correlation between procalcitonin and bacterial community characteristics and prognosis of patients with bacteremia after bone marrow transplantation

Li Shanshan, Bao Huizhang, Sun Yi,Wang Chunyan, Jia Mei

2021, 42(5):  726-732.  doi:10.3969/j.issn.1006-7795.2021.05.006

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Objective To investigate the correlation between procalcitonin (PCT) and bacterial bloodstream infection in the prediction of systemic bacterial infection and prognosis for the patients after bone marrow transplantation. Methods A total of 197 patients with bacterial bloodstream infection after bone marrow transplantation were enrolled and divided into groups according to whether they had agranulocytosis, type of infected bacteria, site of infection, and prognosis of infection. The clinical data were collected, and the blood culture, inflammation and biochemical indexes were detected. The difference of each index between the groups was compared to analyze its clinical significance. Results The PCT in the patients with granulocytopenia was significantly higher than that without granulocytopenia [PCT:1.64(0.25, 10.12) ng/ mL vs 0.76(0.28, 2.72) ng/ mL, P<0.05]. The infection sites of the patients showed the characteristics of patients with immunocompromised blood diseases. The most common infection sites were lung, perianal and digestive system, with no significant difference in PCT between the different infection sites. K-M survival curve analysis showed that the survival rate of the patients with bacteremia after bone marrow transplantation decreased with the increased of PCT. COX analysis showed that PCT, creatinine (CRE), and infection with gram-negative bacteria were the risk factors for infection and death, while albumin (ALB) was the protective factor (all of which were statistically significant). In particular, the gram-negative bacteria infection was a major risk factor for death (HR:3.729,95%CI:1.001-13.888, P=0.05), regardless of grain deficiency and infection site. Conclusion In patients with bacterial bloodstream infection after bone marrow transplantation, the PCT was significantly increased in patients with granulopathy. With the increase of PCT value and gram-negative bacteria infection, the survival rate of bacteremia patients after bone marrow transplantation decreased. The gram-negative bacteria infection was the main risk factor for death.

Study on the virulence features of carbapenem-resistant Klebsiella pneumoniae from invasive abdomen infections

Ma Liyan, Sun Wei, Xia Shuai, Su Jianrong

2021, 42(5):  733-738.  doi:10.3969/j.issn.1006-7795.2021.05.007

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Objective To investigate the virulence features of carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods A total of 38 CRKP clinical strains isolated from invasive abdomen infections were collected. The polymerase chain reaction (PCR) were performed to detect carbapenemase genes (blaKPC-2、blaNDM-1、blaIMP-4、blaVIM-1 and bla_OXA-48), virulence gene (rmpA2) and siderophore gen e(iucA). The CRKP strains were characterized wtih their multilocus sequence typing (MLST) . The capacity of biofilm formation and siderophore production of the isolates were quantitatively tested by crystal violet method and chrome azurol S (CAS) assay, respectively. Results Among 38 CRKPs, 25 strains (25/38, 78.1%) belonged to ST11, which was the predominate clone. Twenty-two strains(22/25, 88.0%)in ST11 group carried bla_KPC-2 only, with the percentage significant higher than that in non-ST11 group. Fifteen ST11 CRKPs (15/25, 60.0%) simultaneously possessed rmpA2 and iucA, and there had no statistical difference between ST11 group and non-ST11 group. Biofilm formation capacity were weaker in non-ST11 group and KPC+rmpA2+iucA group, without statistical differences. The CAS assay showed that the capacity of siderophore production in ST11 group and KPC+rmpA2+iucA group were significantly stronger than that in non-ST11 group and KPC group, respectively. Conclusion The coexistence of bla_KPC-2, rmpA2, and iucA in ST11 CRKPs indicated that strict control measures should be taken to prevent further dissemination.

The value of SAT detection ofhuman cytomegalovirus pp67 mRNA in the clinical diagnosis and treatment of human immunodeficiency virus patients with human cytomegalovirus infection

Meng Huan, Wang Shuang, He Chaonan, Han Ying, Pan Meichen, Yin Shangqi, Zheng Mei, Jin Fangfang, Wang Yajie

2021, 42(5):  739-746.  doi:10.3969/j.issn.1006-7795.2021.05.008

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Objective To investigate the clinical value of simultaneous amplification and testing(SAT) method in detecting human cytomegalovirus(HCMV) phosphoprotein67 (pp67) mRNA in HIV patients with HCMV infection. Methods The SAT technique was used to construct a method for HCMV pp67 mRNA detection, and the repeatability, specificity and detection limit of HCMV pp67 mRNA were evaluated. HCMV pp67 mRNA was detected in serum, alveolar lavage fluid and cerebrospinal fluid samples from 69 HIV-positive patients with active HCMV infection, 154 HIV-positive patients with inactive/latent HCMV infection and 79 HIV-negative patients with inactive/latent HCMV infection. Specificity, sensitivity, accuracy, negative predictive value, positive predictive value, and Youden index were evaluated to evaluate the clinical value of HCMV pp67 mRNA in the identification of HCMV active infection. Results The precision (coefficient of variance<10%) of HCMV pp67 mRNA detected by SAT could meet the clinical requirements. There was no cross-reaction with other pathogens, and the specificity was good. The specificity was 87.55%, the sensitivity was 60.87%, the accuracy was 81.46%, the negative predictive value was 0.88, the positive predictive value was 0.59, and the Youden index was 0.48. There was no significant difference between the positive rate of pp67 mRNA detected by SAT and the clinical diagnosis (P=0.894). Conclusion The SAT method used in the detection of the HCMV pp67 mRNA can be used for auxiliary diagnosis of HCMV active infection.

Application of the mRNA of IL-6,TNF-α,GR-α and GR-β in evaluating the glucocorticoids sensitivity of patients with common orbital diseases

Zhao Ke, Ma Jianmin, Xiao Fei, Liu Xiangyi

2021, 42(5):  747-753.  doi:10.3969/j.issn.1006-7795.2021.05.009

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Objective To analyze the glucocorticoids (GC) sensitivity of patients with thyroid-associated ophthalmopathy (TAO) and idiopathic orbital inflammatory pseudotumor (IOIP) based on laboratory indicators of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), glucocorticoid receptor(GR)-α and GR-β. Methods A total of 62 TAO patients and 36 IOIP patients from the Eye Tumor Clinic of Beijing Tongren Hospital, Capital Medical University were enrolled and divided into glucocorticoid sensitive and resistant groups (GCR group). The EDTA-K2 peripheral anticoagulant blood of the patients was collected, and it was divided into treatment group and control group. The blood sample in the treatment group was treated with dexamethasone at final concentration of 100 nmol/L at room temperature for 7h, while the control group was treated with an equal volume of dimethy1 sulfoxide. The real-time fluorescent quantitative PCR (q-PCR) was applied to detect the mRNA of IL-6, TNF-α, GR-α and GR-β subtype from patient's peripheral blood leukocyte to analyze and evaluate the sensitivity of patients to GC. The diagnostic efficacy of the detection indicators was analyzed by receiver operating characteristic (ROC) curve, and the area under the ROC curve (AUC) was compared with each other. Results Comparison of the sensitive group with the GCR group in TAO patients indicated that the differences of IL-6, TNF-α, GR-α and β were not statistically significant (P>0.05), the AUC of the ratio of GR-α/β in TAO patients was 0.70 (95%CI: 0.54-0.87) and the critical value was 1.255. Comparison of the sensitive group with the GCR group in IOIP patients indicated that there was no significant difference in IL-6, TNF-α, and GR-α, but statistical significant differences in GR-β and GR-α/β (P<0.05), the AUC of the ratio of GR-α/β in IOIP patients was 0.77 (95% CI: 0.58-0.95) and the critical value was 1.005. Conclusion GR-α/β could be an indicator for predicting the sensitivity of TAO and IOIP patients to GC.

Efficacy of Traditional Chinese Medicine for Neuropsychiatric Diseases

Effects of cornel iridoid glycoside on the behavioral and pathological changes on senescence-accelerated mouse prone 8

Ma Denglei, Li Yanzheng, Zhu Yanqiu, Li Lin, Zhang Lan

2021, 42(5):  754-760.  doi:10.3969/j.issn.1006-7795.2021.05.010

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Objective To investigate the effects of cornel iridoid glycoside (CIG) on cognitive behavioral and Alzheimer's-like pathological changes in senescence-accelerated mouse prone 8 (SAMP8) mice. Methods The drug of CIG was chronically administered with intragastric injection to 8-month-old SAMP8 mice and senescence accelerated mouse/resistant 1 (SAMR1) mice in the control for two months. The locomotor activity was tested by the locomotor activity system. The passive avoidance memory function was measured by step through test. The Western blotting was used to detect the expression of amyloid precursor protein amyloid precursor protein (APP) and synapse associated protein. Results The results showed that SAMP8 mice exhibited impaired locomotor activity and cognition. Intragastric administration of CIG for 2 months obviously improved the locomotor activity and cognitive function of SAMP8 mice. CIG treatment elevated the levels of soluble APPα fragment, a disintegrin and metalloproteinase 10 (ADAM10) and insulin-degrading enzyme (IDE). Moreover, CIG increased the expression of synaptophysin, postsynaptic density protein 95, AMPA receptor subunit 1 and phosphorylation of calmodulin dependent protein kinase IIα (CaMKIIα). Conclusion CIG may be beneficial to treating the aging induced cognitive impairment and Alzheimer's-like pathological changes.

Effects of icariin on the behavioral changes, demyelination and neuroinflammation in mice with cuprizone-induced schizophrenia

Chen Xi, Ma Denglei, Li Lin

2021, 42(5):  761-767.  doi:10.3969/j.issn.1006-7795.2021.05.011

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Objective To investigate the effects of icariin (ICA) on the behavioral and pathological changes in the mice with cuprizone induced schizophrenia. Methods The model was established by feeding 0.2% cuprizone-containing fodder for 5 weeks in C57BL/6 mice. The behavioral changes were detected by open-field test and Y-maze test. The oil red O staining was applied to observe the demyelination, and the immunohistochemical method was used to detect the expression of myelin basic protein (MBP) and the number of microglia and astrocytes. Results Compared with the control group, the cuprizone model group showed a lower spontaneous alternation rate (decreased spatial working memory) in the Y-maze test and a longer total course of spontaneous activity (high activity positive symptom) in the open-field test. Moreover, the demyelination, decreased expression of MBP, and increased number of microglia and astrocyte were observed in the corpus callosum of model mice. Intragastric administration of ICA for 5 weeks significantly improved the spatial working memory impairment and the positive symptoms of high activity, reduced the demyelination, increased the expression of MBP, and inhibited the activation of microglia and astrocytes in the corpus callosum of cuprizone model mice. Conclusion ICA could improve the positive symptom and cognitive impairment in the mice with cuprizone-induced schizophrenia, and the mechanisms might be related to the inhibitory effects of ICA on the demyelination and neuroinflammation. These results suggested that ICA may have the potential to treat schizophrenia.

Epimedium flavonoids improve white matter lesions induced by chronic cerebral hypoperfusion in rats

Zhang Li, Wang Mingyang, Niu Hongmei, Zhang Lan, Li Lin

2021, 42(5):  768-775.  doi:10.3969/j.issn.1006-7795.2021.05.012

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Objective To investigate the effects of epimedium flavonoids (EF) on white matter lesions induced by chronic cerebral hypoperfusion in rats. Methods Male SD rats were subjected to permanent bilateral common carotid artery ligation (2VO) surgery. All rats were randomly divided into 5 groups: sham group, model group, EF 100 mg/kg group, EF 200 mg/kg group and nimodipine group. Drugs were administered intragastrically at 24 h after surgery for 6 weeks. The new object recognition test was used to assess the spatial memory recognition ability of rats. Diffusion tensor imaging was used to detect the changes of microstructure and fractional anisotropy coefficient (FA), apparent diffusion coefficient (ADC), axial diffusion coefficient (AD) and radial diffusivity coefficient (RD) in corpus callosum and optic tract of white matter in 2VO model rats. White matter structure was also observed with luxol fast blue (LFB) staining. Results After 2VO surgery the discrimination index in the new object recognition test significantly decreased, the value of FA decreased, and the RD value increased, indicating the damage of white matter in 2VO rats. In addition, the grading score of LFB staining was significantly downregulated. While treatment with EF increased the discrimination index, reduced the microstructure damage of corpus callosum and optic tract, protected the integrity of nerve fibers, decreased the grading score of LFB staining in corpus callosum of 2VO model rats, alleviated the demyelination of myelin. Conclusion EF treatment could reduce the structural abnormalities of the myelin sheath in rats after 2VO operation, alleviate the lesion of white matter, and improve the learning and memory dysfunction in 2VO rats.

Basic Research

Establishment and preliminary application of DELFIA detection method for 129 serine phosphorylated α-synuclein

Gao Ge, Zha Xu, Liu Weijin, Yang Hui

2021, 42(5):  776-782.  doi:10.3969/j.issn.1006-7795.2021.05.013

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Objective To establish an dissociation enhanced lanthanide fluorescent immunoassay (DELFIA) method for detection of 129 serine phosphorylated α-synuclein. Methods Human α-syn protein monomer (α-syn) was purified by in vitro protein recombination technique. Phosphorylated α-syn monomer (p-α-syn) was obtained by using pololike kinase to catalyze α-syn. Aggregates of α-syn (OW) and aggregates of p-α-syn (OP) were prepared by 4-oxo-nonenal. Western blotting and indirect ELISA were used to verify the polyclonal antibody SN16 and monoclonal antibody C140S which recognized the N-terminal of α-syn protein and phosphorylated S129-α-syn. The standard curve for the detection of OP was established by sandwich DELFIA by using SN16 as capture antibody and C140S as detection antibody, and the changes of OP in the plasma of Thy1-α-SYN transgenic mice was detected. Results Coomassie brilliant blue staining and Western blotting showed that the purity of human α-syn protein monomer (17 000) was high, and p-α-syn, OW and OP were obtained by catalysis in vitro, which could be used as standard antigens for establishing standard curve. Western blotting and ELISA results showed that SN16 could recognize α-syn, p-α-syn, OW and OP, and C140S could recognize p-α-syn and OP, indicating that SN16 and C140S could be used as paired detecting antibodies. Indirect DELFIA results showed that C140S had better recognition efficiency for OP. Sandwich DELFIA showed that the range of antigen was 0.625 ng/mL to 20 ng/mL by using SN16-C140S as the paired antibody. The standard curve of identifying OP was established. The content of OP in 12-month-old mice plasma of Wt and Tg groups was higher than that of 6-month-old mice (P<0.001). The level of OP in 6-month-old Tg mice plasma was significantly higher than that of the same month-old mice in Wt group (P<0.001). The level of OP in the plasma of 12-month-old Tg mice was higher than that of Wt group, but there was no statistical difference (P>0.05). Conclusion Sandwich DELFIA method was established to detect aggregated OP in the plasma of Thy1-α-SYN transgenic mice by using SN16-C140S antibody.

Omi/HtrA2 overexpression is associated with myocardial aging

Wei Xin, Liu Dan, Wu Ye, Lyu Kunyi, Shen Yan, Liu Huirong

2021, 42(5):  783-789.  doi:10.3969/j.issn.1006-7795.2021.05.014

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Objective To observe the effect of increased serine protease Omi/HtrA2 on myocardial aging. Methods Overexpressed cardiac-specific Omi/HtrA2 transgenic mice was constructed, the expression of senescence markers p53, p21 and p16 were detected by Western blotting, and the correlation between Omi/HtrA2 and the senescence markers was analyzed. The aging indicators were detected in overexpressed Omi/HtrA2 H9c2 cells (Omi group) by Western blotting. The senescent cells were detected by β-galactosidase staining. Compared with overexpressed Omi/HtrA2 cells, the expression of senescence markers and the β-galactosidase positive senescent cells were detected after inhibiting the function of Omi/HtrA2 by Omi/HtrA2 specific inhibitor UCF101. Results (1) Compared with the control group, the expression of Omi/HtrA2 was significantly increased in the heart of myocardium-specific overexpressed Omi/HtrA2 transgenic mice (P<0.01). The aging markers p53, p21 and p16 were significantly increased in Omi/HtrA2 overexpressed group(P<0.01). (2) The expression of Omi/HtrA2 was positively correlated with the aging markers p53, p21, and p16 (P<0.01). (3) Compared with H9c2 cells (control group), expression of the senescence markers p53, p21 and p16 and the β-galactosidase positive senescent cells increased in Omi group (P<0.05). Compared with Omi group, expression of the senescence markers and the β-galactosidase positive senescent cells decreased in Omi/HtrA2 H9c2 cells treated by Omi/HtrA2 specific inhibitor UCF101 (Omi+UCF101 group) (P<0.05). Conclusion The expression of Omi/HtrA2 is positively correlated with aging markers. Overexpression of Omi/HtrA2 promoted myocardial aging.

Effect of Magnolia officinalis decoction on Candida albicans and its biofilm

Xiang Xiaobo, Yan Lyubing, Zhou Yanmeng

2021, 42(5):  790-798.  doi:10.3969/j.issn.1006-7795.2021.05.015

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Objective To observe the effects of Magnolia officinalis decoction on the formation of germ tube, the early adhesion gene and mature biofilm of Candida albicans(C.albicans). Methods Bud tube formation test was used to detect the effect of Magnolia officinalis decoction on the formation of bud tube C. albicans. The expression of agglutinin-like sequencefamily (ALS1), ALS2 and ALS3 genes was detected in real-time using fluorescence quantitative real-time PCR (qRT PCR). The effects of Magnolia officinalis decoction on the biofilm of C. albicansat maturity were observed using fluorescence microscope and scanning electron microscope(SEM). The effect of Magnolia officinalis decoction on bacterial activity in biofilm was observed by confocal microscope. Results The results obtained from the formation of germ tube test showed that Magnolia officinalis decoction could inhibit the formation of germ tube C.albicans in a concentration dependent manner (P<0.05). Magnolia officinalis decoction could reduce the expression of ALS1, ALS2 and ALS3 genes in a concentration dependent manner (P<0.05).Under fluorescence microscope, the biofilm in the blank control group was mainly mycelium. The biofilm structure was destroyed after the Magnolia officinalis decoction for 24, 48 and 72. SEM results also showed that Magnolia officinalis decoction could result in the destruction of the biofilm structure. Confocal microscopy showed that C. albicans in the blank control group was mainly living bacteria, and the number of dead bacteria increased significantly after 48 hours of Magnolia officinalis decoction at 15.625 mg/L. Conclusion The Magnolia officinalis decoction can inhibit the early adhension of C. albicans by down regulating ALS1, ALS2 and ALS3 genes.At the same time,it can promote the entry of drugs into biofilm by destroying the structure of mature biofilm in inhibit the formation of germ tube and play a bactericidal role.

Clinical Research

Analysis on influencing factors of antiplatelet drug resistance in patients with acute coronary syndrome

Yao Yi, Tang Xiaofang, Song Ying, Jiang Lin, Qiao Shubin, Yuan Jinqing

2021, 42(5):  799-803.  doi:10.3969/j.issn.1006-7795.2021.05.016

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Objective To analyze the influencing factors of antiplatelet drug clopidogrel resistance in patients with acute coronary syndrome, so as to help clinicians quickly identify patients who may be resistant to antiplatelet therapy. Methods This study included patients with acute coronary syndrome who received coronary intervention and on dual antiplatelet at Fuwai Hospital throughout 2013. According to the results of thromboelastography (the result recorded as ADP-induced platelet-fibrin clot strength, MAADP,) the selected patients were divided into resistance group (MA_ADP>47 mm) and non-resistance group (MA_ADP≤47 mm). Via clinical data, univariate and multivariate logistic regression analysis were used to screen out influencing factors independently related to clopidogrel treatment resistance. Results A total of 2 511 patients were enrolled in the study, among them 781(31.10%) patients had clopidogrel treatment resistance. After univariate and further multivariate logistic regression analysis, five clinical factors were screened to be independently associated with resistance to antiplatelet therapy, namely reduced renal function (OR=3.08, 95%CI:1.28-7.36); female (OR=2.86, 95%CI:2.26-3.61); diabetes mellitus (OR=1.61, 95%CI:1.33-1.95); elevated platelet count (OR=1.55, 95%CI:1.07-2.25) and proton pump inhibitor use (OR=1.25, 95%CI:1.02-1.54). Conclusion Reduced renal function, female, diabetes, elevated platelet count and the use of proton pump inhibitors are the independent influencing factors of antiplatelet drug clopidogrel resistance in patients with acute coronary syndrome, which need to be paid attention in the clinical treatment, thereby guiding individualized antiplatelet therapy.

Analysis of risk factors of cardiovascular disease in elderly hypertensive population in Tianjin community

Liu Jin, Qi Xin, Qi Yanfang, Feng Jiaojiao, Peng Jinling

2021, 42(5):  804-809.  doi:10.3969/j.issn.1006-7795.2021.05.017

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Objective To predict the risk and trends of 10-year risk for cardiovascular diseases in elderly hypertensive population and to provide foundation data for the prevention and treatment of ischemic cardiovascular disease(ICVD). Methods Baseline data in 2016 and those of return visit in 2017 from 972 elderly hypertensive patients were collected and processed. Risk assessment and stratification of 10-year risk for cardiovascular disease(CVD) were conducted according to ICVD model. Results Compared with 2016, the absolute risk of 10-year risk of ICVD was much higher in 2017, raised from 12.8% to 16.8%(P＜0.01). In 2016, the proportion of the participants with high ICVD risk was raised from 59.3% to 67.7% (P＜0.01).Analysis on 154 patients with increased ICVD risk in this population revealed that body mass index (BMI), waist circumstance (WC), systolic blood pressure(SBP), blood glucose, blood lipids, blood urea nitrogen (BUN) and creatinine (Cr) were increased (P<0.01), the prevalence of overweight and obesity, hypercholesterolemia, hypertriglyceridemia, diabetes, metabolic syndrome, and impaired renal function were increased (P<0.01), suggesting that the increased 10-year risk of154 ICVD patients is related to the increase of these factors. Conclusion The level of cardiovascular disease risk factors in elderly hypertensive population in Tianjin community is relatively high, and is showing an upward trend. The risk of ICVD in the next 10 years is relatively high, and effective intervention should be strengthened according to risk factors.

The relationship between plasma D-lactate level and small intestinal damage in patients taking aspirin

Chen Xue, Gao Feng, Zhang Jie

2021, 42(5):  810-815.  doi:10.3969/j.issn.1006-7795.2021.05.018

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Objective To investigate the relationship between plasma D-lactate level and small intestinal damage in patients taking aspirin. Methods From May 2019 to December 2019, 106 patients who had been taking aspirin for over one month in Beijing Anzhen Hospital, Capital Medical University were enrolled. They were examined by magnetically controlled capsule endoscopy. According to the five-point scoring system for endoscopic lesions with capsule endoscopy, patients with normal small intestinal mucosa were divided into the normal group, those with erythema or 1-4 small erosions were divided into the mild damage group, and those with more than 4 small erosions or large erosions/ulcers were divided into the major damage group. The expression levels of plasma D-lactate and inflammatory factors interleukin-1β(IL-1β), tumor necrosis factor (TNF-α), interleukin-10(IL-10) were detected by colorimetry and enzyme-linked immunosorbent assay, respectively. The efficacy of D-lactate in the diagnosis of severe small intestinal damage was evaluated by receiver operating characteristic(ROC) curve. Results Among the 106 patients taking aspirin, 14 cases were in the normal group, 74 cases were in the mild damage group and 18 cases were in the major damage group. The plasma D-lactate levels of the three groups were 106.59 (70.17, 278.11) nmol/mL, 167.19 (31.81, 439.57) nmol/mL and 349.88 (182.23, 1 442.5) nmol/mL, there was significant difference among the three groups (P=0.022). The area under ROC curve was 0.704 (95% CI: 0.572-0.836, P=0.006). The level of D-lactate (754.15 nmol/mL) corresponding to the maximum point of Youden index was taken as the cut-off point. When D-lactate level≥754.15 nmol/ml, the sensitivity, specificity and kappa were 44.4%, 90.9% and Kappa=0.370, respectively,the predicted effect was poor. Conclusion The levels of plasma D-lactate varies with the degree of small intestinal damage in patients taking aspirin. However, the effect of plasma D-lactate level in predicting aspirin related severe small intestinal damage is not ideal.

Analysis of influencing factors of exhaust time in patients undergoing neurosurgery

Miao Fangfang, Feng Xuexin, Hou Ruixue, Duan Qingfang, Wang Tianlong

2021, 42(5):  816-821.  doi:10.3969/j.issn.1006-7795.2021.05.019

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Objective To analyzes the risk factors of patients who did not exhaust 24 h after neurosurgery, and to provide guidance for early interventions to restore the patients' gastrointestinal function as soon as possible. Methods Patients who underwent neurosurgery were divided into ≤24 h exhaust group and >24 h exhaust group, and their demographics, intraoperative and postoperative details were compared. Results Among the 2 446 patients, 897 (36.7%) did not exhaust 24 h after neurosurgery. The variables associated with this condition in univariate analysis were gender (female vs male), estimated blood loss volume, whether to infuse suspended red blood cells, operation time (≥4 h vs <4 h), numerical rating scales (NRS) scores at rest and during movement at postoperative 6 h and 24 h (>3 vs ≤3), and whether there was nausea and vomiting at postoperative 6 h and 24 h (all P<0.05). Binary Logistic regression analysis showed that female gender (B=0.333, OR=1.395, P<0.001), operation time ≥4 h (B=0.383, OR=1.467, P<0.001), and nausea and vomiting at postoperative 24 h (B=0.585, OR=1.794, P<0.001) were independent risk factors for patients who did not exhaust 24 h after neurosurgery. Conclusion The results in this study suggested the clinicians should pay close attention to patients with independent risk factors (female gender, operation time ≥4 h, and nausea and vomiting at postoperative 24 h) to accelerate the recovery of gastrointestinal function in patients undergoing neurosurgery.

Association between hepatic insulin clearance,clinical characteristics and gut hormone in Chinese patients with newly diagnosed type 2 diabetes mellitus

Zhang Dongxue, Wen Zhen, Sun Yuyan, Jiang Tao

2021, 42(5):  822-828.  doi:10.3969/j.issn.1006-7795.2021.05.020

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Objective To explore the correlation between hepatic insulin clearance (HIC) and insulin resistance, β cell function and gut hormone in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods Clinical data from newly diagnosed Chinese T2DM patients was collected. A 120-min oral glucose tolerance test (OGTT) was conducted. Meanwhile, serum glucose, insulin, C peptide, gastric inhibitory polypeptide(GIP), glucagon-like peptide-1(GLP-1) and ghrelin at 0, 30, 60 and 120 min were all detected during OGTT. HIC was calculated from OGTT results. Patients were divided into high HIC group and low HIC group according to HIC levels. Clinical characters and gut hormones were compared between the two groups. Results Concentrations of glucose after OGTT in high HIC group were significantly higher than those in low HIC group (P<0.05). Homeostasis model assessment-IR (HOMA-IR) was increased and Matsuda index was decreased in low HIC group compared with high HIC group (P<0.05). Meanwhile, homeostasis model assessment-β (HOMA-β) was lower in patients with higher HIC (P<0.05). Importantly, patients in high HIC group were found with lower fasting ghrelin, and poorer ghrelin inhibition at 120 min after 75 g glucose load (P<0.05). Neither base levels nor concentrations during OGTT were different in GIP and GLP-1 analysis. Conclusion In Chinese patients with newly diagnosed T2DM, higher HIC is correlated with poorer islet function, while lower HIC is found in patients with relatively severe insulin resistance. Moreover, gut hormone ghrelin may be associated with hepatic insulin clearance. This research may provide new evidences for diabetes prevention and treatment in Chinese patients.

The efficacy and prognostic value of maximum standard uptake on baseline ¹⁸ F-FDG PET/CT in B-cell non-Hodgkin's lymphoma

Guo Xiaochuan, Zhang Weijing, Wang Bin, Wang Weixia, Huang Lefu, Cao Baoping, Zhong Kaili

2021, 42(5):  829-835.  doi:10.3969/j.issn.1006-7795.2021.05.021

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Objective To evaluate the efficacy and prognostic value of maximum standardized uptake (SUV_max) of ¹⁸F-flurodeoxyglucose positron emission tomography/computed tomography(¹⁸F-FDG PET/CT) in B-cell non-Hodgkin's lymphoma (NHL). Methods A total of 47 patients with B-cell non-Hodgkin's lymphoma treated in Beijing Shijitan Hospital, Capital Medical University from August 2016 to September 2019 were retrospectively analyzed. The correlation between baseline SUV_max and clinicopathological factors, laboratory indexes was evaluated. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal point of SUV_max for disease progression, and the prognostic value of SUV_max was analyzed. Results ①There were significant differences between the baseline SUV_max and lactic dehydrogenase(LDH) level, progression status within 1 year, pathological types, respectively; ②Take the 1-year progression rate as the cut-off point, the optimal point of SUV_max was 14.4, the median progression-free survival (PFS) and overall survival (OS) of patients with SUV_max＜14.4 were significantly higher than those with SUV_max≥14.4,P<0.05; ③Take the disease progression as the cut-off point, the optimal pointof SUV_max was 16.7, the median PFS of patients with SUV_max＜16.7 were significantly higher than those with SUV_max≥16.7,P=0.025. Conclusion Baseline SUV_max of patients with B-cell lymphoma is closely related to the curative effect and survival, which has great clinical value.

Rotarex thrombectomy combined with drug-coated balloon for femoropopliteal artery in-stent restenosis: 3 years follow up results

Liao Chuanjun, Song Shenghan, Zhang Wangde

2021, 42(5):  836-840.  doi:10.3969/j.issn.1006-7795.2021.05.022

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Objective To evaluate the effectiveness and safety of Rotarex thrombectomy combined with drug-coated balloon(DCB) for treatment of femoropopliteal artery in-stent restenosis(FP-ISR). Methods From June 2016 to July 2017, 32 FP ISR patients received Rotarex thrombectomy combined with DCB, which were followed up for 3 years. The primary endpoint was primary patency of the target lesion and freedom from clinically-driven target lesion revascularization (CD-TLR) at 3 years. The secondary endpoint was the rate of major adverse limb events (MALE), amputation and mortality. The primary functional endpoint was assessed by Walking Impairment Questionnaire (WIQ). Results Technical and procedural success was achieved in all 32 patients, 27(84.4%) patients completed 3 years follow-up. Mean ABI was 0.45±0.14 at baseline and 0.81±0.10 at 3 years (P<0.05). The WIQ score was 30.45±21.14 at baseline and 51.32±27.92 at 3 years (P<0.05). The Kaplan-Meier estimate of the primary patency rate at 3 years was 81.5%, freedom from CD-TLR rate at 3 years was 85.2%. Conclusion Rotarex thrombectomy combined with DCB for treatment of FP ISR is safe and effective, the medium and long-term results are satisfactory.

Assessment of anxiety, depression and sleep disorder on patients with hyperhidrosis

Lin Xuefei, Wu Nan, Zhang Haiping

2021, 42(5):  841-846.  doi:10.3969/j.issn.1006-7795.2021.05.023

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Objective To observe the anxiety, depression and sleep status of patients with hyperhidrosis,to explore the relationship between hyperhidrosis and emotions, so as to provide basis for cognitive and psychotherapy of hyperhidrosis. Methods Patients with hyperhidrosis in dermatology Department of Xuanwu Hospital were recruited and divided into groups according to gender, age, education background, working environment and nature of work. The state of anxiety, depression and sleep was assessed by using Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI). Results A total of 163 patients with hyperhidrosis were included in this study. There were 47 patients (28.83%) with positive anxiety symptoms, 146 patients (89.57%) with positive depression symptoms and 53 patients (32.52%) with sleep disorder. The scores of anxiety and depression of HADS were respectively (6.47±2.89) and (10.29±2.22), which were significantly higher than the domestic norm (P<0.05). PSQI score was(6.21±3.16). The scores of anxiety and depression for sleep disorders were(8.13±3.49)and(9.51±2.22). The PSQI score of patients with positive anxiety symptoms was higher (P<0.05). There were no significant differences in anxiety, depression and sleep among patients with different gender, age, education background and work environment (P>0.05). PSQI score of indoor workers was higher than that of outdoor workers(P<0.05). Conclusion Patients with hyperhidrosis have significant anxiety and depression, and the depression is more serious. Patients with sleep disorders had anxiety and depression. Anxiety patients generally have sleep disorders. The sleep quality of indoor workers was worse than that of outdoor workers.

Value of emergency chest pain score in predicting the risk of emergency chest pain

Wang Yu, Han Jing, Cao Xiaojing, Jin Zening

2021, 42(5):  847-851.  doi:10.3969/j.issn.1006-7795.2021.05.024

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Objective To evaluate the value of Emergency Department Assessment of Chest Pain Score (EDACS) in predicting the risk of patients with chest pain, especially with acute coronary syndrome (ACS). Methods The scores were calculated by EDACS, patients with less than 16 scores were regarded as low-risk patients, and patients with more than 16 scores were regarded as high-risk patients. To compare the EDACs of patients with cardiogenic chest pain and non-cardiogenic chest pain, ACS and non ACS,acute myocardial infarction and unstable angina pectoris. The sensitivity and specificity of EDACs were calculated respectively. Results The EDACs of patients with cardiogenic chest pain, especially ACS, was significantly higher. The score of patients with myocardial infarction was similar to that of patients with unstable angina pectoris. If the patient with EDACs≥16 was diagnosed with cardiogenic chest pain,the sensitivity and specificity were 71.77% and 87.62%, respectively. If the patient with EDACs≥16 was diagnosed with ACS,the sensitivity and specificity were 72.92% and 83.98%, respectively. If the patient with EDACs≥16 was diagnosed with acute myocardial infarction,the sensitivity and specificity were 71.02% and 25.31%, respectively. Conclusion Patients with cardiogenic chest pain, especially ACS, can be distinguished by EDACS, but patients with acute myocardial infarction and unstable angina pectoris can not be.

Analysis of 10-year death data of children aged 0-16 in single-center pediatric outpatient and emergency department

Wu Hongbo, Li Manman, Lin Lili, Li Lihua

2021, 42(5):  852-856.  doi:10.3969/j.issn.1006-7795.2021.05.025

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Objective Through retrospective analysis of the cases of children and adolescents from 0 to 16 years old in the Emergency Department of Beijing Luhe Hospital, Capital Medical University, the causes and characteristics of the deaths of children and adolescents in the emergency department were studied, so as to find the entry point for treating children with acute severe diseases and reducing the deaths of children in the emergency department, and provide clinical basis for the development of prevention and treatment strategies for reducing the mortality of children and adolescents. Methods From the “Population Death Information Registration and Management System”, the death data of children under 16 years of age were collected in our hospital from January 2009 to December 2019 and divided into neonatal groups according to different age groups (≤28 days), infant group (>28 days-≤1 year old), children group (>1-≤3 years old), preschool group (>3-≤6 years), school age group (>6 years-≤10 years), and the adolescent group (>10 years old-≤16 years old). Results The main causes of death in children and adolescents were found to be accidental injury death, sudden death, end-stage disease, respiratory failure and respiratory and cardiac arrest. The first cause of death was accidental injury, accounting for 40.00%, followed by sudden death, accounting for 15.00%, followed by respiratory failure and end-stage disease, accounting for 13.00%, respectively. Among unintentional injury deaths, the ratio of males to females was 1.86 to 1. Traffic injuries accounted for the first place (42.50%), followed by fall/fall injuries (25.00%). There were age differences in the death of children, and traffic injury was the main injury type in the adolescent group (42.85%). Traffic injuries and fall/fall injuries were the main injury types in the preschool, school and infant groups, while traffic injuries (28.57%) and foreign bodies (28.57%) were the main injury types in the infant group, followed by fall/fall injuries (14.28%), drowning (14.28%) and poisoning (14.28%). The place where children died on the way to the hospital was the first, followed by 32.00% at home, and the place where children died before the hospital accounted for 69%. The number of children who died before the hospital was significantly higher in the neonatal period and infant period than that of the pre-school and school-age groups. Conclusion The top three causes of death in emergency care for children aged 0-16 years in Tongzhou district were accidental injury death, sudden death, respiratory failure and terminal disease. The causes of death were different in different age groups, and the place of death was mostly pre-hospital. The younger the age was, the higher the risk of pre-hospital death was, and the risk of boys were more than that of girls.

Clinical effect of photodynamic therapy combined with liquid nitrogen freezing on the treatment of condyloma acuminatum

Cui Yuli

2021, 42(5):  857-861.  doi:10.3969/j.issn.1006-7795.2021.05.026

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Objective To discuss and study the clinical effect of photodynamic therapy combined with liquid nitrogen cryotherapy on the treatment of condyloma acuminatum. Methods Totally 100 adult patients with condyloma acuminatum were randomly divided into two groups. The control group was treated with photodynamic therapy, and the observation group was treated with photodynamic therapy combined with liquid nitrogen freezing. The total effective rate, recurrence rate, adverse incidence rate, and wart removal before and after treatment were compared. Rate and the distribution of 21 HPV genes. Results The total effective rate of the observation group was 96%, the recurrence rate was 6%, and the incidence of adverse reactions was 10%; the total effective rate of the control group was 90%, the recurrence rate was 26%, and the incidence of adverse reactions was 38%. After treatment, the diameter of warts in the observation group shorter than the control group, the difference between the two groups is statistically significant (P<0.05). Conclusion Compared with the single application of photodynamic therapy, photodynamic combined with liquid nitrogen cryotherapy has a significant effect on the treatment of condyloma acuminatum, with high treatment efficiency, high wart clearance rate, low recurrence rate and adverse reaction rate, and it is worthy of clinical promotion.

Review

Progress in neoadjuvant immunotherapy for resectable non-small cell lung cancer

Tan Xiaogang, Zhang Yi

2021, 42(5):  862-867.  doi:10.3969/j.issn.1006-7795.2021.05.027

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Resectable non-small cell lung cancer (NSCLC) is known as a potentially curable disease. Radical surgery or adjuvant chemotherapy and radiotherapy is the standard treatment, but quite a few patients will have local recurrence and distant metastasis after surgery. More recent publications indicate that immune checkpoint blockade may have better potential in neoadjuvant therapy, with reported major pathological response rates of 20% to 85%, compared to chemotherapy alone. This review intends to summarize the efficacies and potential risks of neoadjuvant targeted therapy and immunotherapy in patients with NSCLC. With more and more independent research and development of immune checkpoint inhibitors listed in China,we discussed the future developments in neoadjuvant therapy.

Diagnosis and treatment of primary bladder neck obstruction or primary bladder neck dyssynergia

Qin Yan, Wu Liyang, Zhang Peng, Hu Xiaopeng

2021, 42(5):  868-873.  doi:10.3969/j.issn.1006-7795.2021.05.028

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Primary bladder neck obstruction or primary bladder neck dyssynergia (PBNO/PBND) is a set of specific bladder neck obstruction syndrome, the precise cause of PBNO/PBND has not been clearly elucidated, PBNO/PBND may present with a variety of symptoms, including voiding symptoms (dysuria, hesitation, straining, incomplete emptying), storage symptoms (frequency, urgency, urinary incontinence, nocturia) or a combination of both. It is considered that video-urodynamic study (VUDS) is the gold standard for the diagnosis of this disease, PBNO/PBND is a video urodynamic diagnosis whose hallmarks include high-pressure low-flow voiding, and radiographic evidence of bladder neck is not open or incomplete. Treatment for some patients with slight symptoms can choose observation, pharmacological treatment and clean intermittent self-catheterization, for patients who failed to receive conservative treatment should be performed transurethral bladder neck incision. To further understand PBNO/PBND and its progress, this article reviews the relevant research progress.

Nobel Prize

Voyage of discoveries of sensory decoders—Introduction of the Nobel Prize in Physiology or Medicine 2021

Wang Peipei, Yang Fei

2021, 42(5):  879-882.  doi:10.3969/j.issn.1006-7795.2021.05.030

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On October 4, 2021, Beijing time, the Karolinska Institute of Sweden in Stockholm announced that the 2021 Nobel Prize in Physiology or Medicine was awarded to American physiologist David Julius and American molecular biologist Ardem Patapoutian in recognition of their outstanding contributions in discoveries of receptors for temperature and touch.Here, we will give the introductions of David Julius and Ardem Patapoutian as well as their scientific contributions and significance underlying those.

Asymmetric organocatalysis: making pharmaceutical development simple—Introduction of the Nobel Prize in Chemistry 2021

Li Yuanyuan, Feng Qiqi, Zhang Xiaoyi, Wang Yuji, Zhao Ming

2021, 42(5):  883-887.  doi:10.3969/j.issn.1006-7795.2021.05.031

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On October 6, 2021, the Royal Swedish Academy of Sciences announced that the Nobel Prize in Chemistry 2021 was awarded to German chemist Benjamin List and the American chemist David W.C. MacMillan, in recognition of their outstanding contributions in the development of asymmetric organocatalysis.

Lasker Awards

Optogenetics—The 2021 Albert Lasker Basic Medical Research Award

Gong Ping, Xu Zhiqing

2021, 42(5):  888-892.  doi:10.3969/j.issn.1006-7795.2021.05.032

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Optogenetics has attracted considerable attention since its discovery. This groundbreaking technology was created to help us accurately explore the neural circuits and function. Therefore, optogenetics has collected many scientific awards. In this article, the development and principle of optogenetics are introduced briefly.

Progress in mRNA vaccine—The 2021 Lasker Clinical Medicine Research Award

Chen Yan, Sun Ying

2021, 42(5):  893-889.  doi:10.3969/j.issn.1006-7795.2021.05.033

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The 2021 Lasker Clinical Medicine Research Award is awarded to biochemist Katalin Karikó and immunologist Drew Weissman who have made significant contributions to the research and development of mRNA vaccines. However, the current understanding of such vaccines is still insufficient. Messenger RNA (mRNA) vaccine is to synthesize mRNA sequence encoding a given specific antigen in vitro, which can be delivered into the body and express the corresponding protein. In turn, the antigenic protein encoded by the mRNA vaccine is able to induce an immune response against the specific antigen protein, which can prevent and treat a certain disease. As a new type of vaccine, mRNA vaccine has the characteristics of high transfectional efficiency, strong ability for immune stimulation, good safety, rapid industrialization and low cost, etc. The application of mRNA vaccine in the prevention and theraputis of some infectious diseases and cancers has shown its unique advantages.